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chronic surgical pain

Nicola Krähenbühl, Maxwell W Weinberg, Beat Hintermann, Justin M Haller, Charles L Saltzman, Alexej Barg
BACKGROUND: Chronic injuries of the distal tibio-fibular syndesmosis often present with non-specific clinical and radiographic findings. If chronic instability to the distal tibio-fibular syndesmosis is verified, various reconstruction options are available. The purpose of this article is to give a systematic review of current surgical treatment options in patients with chronic syndesmotic injury. METHODS: Three major medical databases were searched from inception through December 12, 2017: PubMed, ScienceDirect, and SpringerLink...
August 30, 2018: Foot and Ankle Surgery: Official Journal of the European Society of Foot and Ankle Surgeons
M Suppa, F Benhadou, M Daxhelet, V Del Marmol
Hidradenitis suppurativa (HS) is a chronic cutaneous disease with a prevalence ranging between 0.05 % and 4 % in the general population. The clinical presentation features painful, inflammatory nodules on the apocrine gland- bearing body regions, evolving later on in fluctuant abscesses, fistulas and hypertrophic scars. HS represents a significant burden for the patients, severely limiting their quality of life. The disease is still relatively unknown by physicians, the time-to-diagnose can be extremely long and the therapeutic measures available are currently limited...
2018: Revue Médicale de Bruxelles
A Pastijn, S Vasseur, F Deneft, M Caillet, F Janssens, S Rozenberg
The ageing of the population, having access to good quality of care, will result in an increase in the prevalence of pelvic floor diseases. Those persons, often in good general health, may experience difficulties in accepting functional pathologies, associated with loss in quality of life. One out of 2 women will have a pelvic floor problem and 1 out of 9 will have a surgical perineal procedure before the age of 80 years. The unitary character of the pelvic floor, a complex functional anatomic region, is often forgotten, essentially because the patients complain about one main pathology like urinary incontinence, genital prolapse, constipation and sexual disorders or chronic pain and will consult one specific specialist...
2018: Revue Médicale de Bruxelles
M Ahmed, S Lutze, M Tembulatow, G Daeschlein, M Jünger, A Arnold
BACKGROUND: Chronic venous disease (CVD) is extremely common worldwide. The prevalence is increasing with age and is associated with a reduced quality of life, particularly in relation to pain, physical function and mobility. Symptomatic chronic venous insufficiency (CVI) with venous ulcer at its' endpoint, indicates interventional surgery to cure venous reflux therewith promoting wound healing and preventing recurrence. To our knowledge up to now no coherent study has been undertaken in patients with CVI who underwent an open venous surgery concerning complications, venous hemodynamics and perioperative symptomology in one study population...
October 11, 2018: Journal of Neuromuscular Diseases
Giuseppe Amato, Giorgio Romano, Roberto Puleio, Antonino Agrusa, Thorsten Goetze, Eliana Gulotta, Luca Gordini, Enrico Erdas, Piergiorgio Calò
Despite undisputed improvements, prosthetics hernia repair continues to be affected by unacceptable rates of complications. Postoperative adverse events such as discomfort and chronic pain represent a subject of increasing concern among the surgical community. Poor quality biologic response, stiff scar plates, and mesh shrinkage, a typical effect of conventional static meshes and plugs, are all indicated as the main reasons for many of the complications related to inguinal hernia repair. Even the conventional concept of treatment based upon a supposed reinforcement of the groin consequent to the fibrotic incorporation of meshes, would appear to be inadequate in the light of the latest scientific evidence concerning the degenerative genesis of inguinal hernia...
October 14, 2018: Artificial Organs
Ruchi Shah, Ravi P Jagani
Endometriosis is characterized as the ectopic presence of endometrium in various locations within the abdominal cavity, such as the fallopian tube, the pouch of Douglas, the ovaries, outside the ovaries, and more. The inner lining of the uterus, endometrium, is a dynamic tissue that undergoes morphological and functional changes cyclically. The proliferation of endometrial cells during menstruation is influenced by increasing circulating estrogen levels. Adult progenitor stem cells are likely responsible for this remarkable regenerative capacity and hence, enhanced capacity to generate endometriosis...
2018: Critical Reviews in Biomedical Engineering
Laxmaiah Manchikanti, Yogesh Malla, Kimberly A Cash, Vidyasagar Pampati, Joshua A Hirsch
Background: Neck and back pain are leading sources of disability placing substantial burden on health care systems. Surgical interventions in managing chronic neck pain secondary to various disorders continue to increase. Even though surgical interventions are effective, a significant proportion of patients continue to have symptomatology and develop cervical post-surgery syndrome. This study was performed to know the effectiveness of cervical interlaminar epidural injections with or without steroids...
October 2018: Korean Journal of Pain
Kevin Cheng, Ranil de Silva
Refractory angina is a significant clinical problem and its successful management is often extremely challenging. Defined as chronic angina-type chest pain in the presence of myocardial ischaemia that persists despite optimal medical, interventional and surgical treatment, current therapies are limited and new approaches to treatment are needed. With an ageing population and increased survival from coronary artery disease, clinicians will increasingly encounter this complex condition in routine clinical practice...
August 2018: European Cardiology
Yanchun Liang, Duo Liu, Fan Yang, Wenwei Pan, Feitianzhi Zeng, Jinjie Wu, Hongyu Xie, Jiaying Li, Shuzhong Yao
Purpose: Recent studies have shown that abnormal distribution of pelvic nerves contributes to endometriosis-associated pain. However, the relationship between neurogenesis and pain severity in endometriosis still remains uncertain, which makes it an enigma for both gynecologists as well as neuropathologists. In this study, we tried to explore a special phenomenon, perineural invasion (PNI), in deep infiltrating endometriosis (DIE) and investigated the correlation between PNI- and DIE-associated pain...
2018: Journal of Pain Research
Danny J Avalos, Irene Sarosiek, Priyadarshini Loganathan, Richard W McCallum
Diabetic gastroparesis (DMGP) is a condition of delayed gastric emptying after gastric outlet obstruction has been excluded. Symptoms of nausea, vomiting, early satiety, bloating, and abdominal pain are associated with DMGP. Uncontrolled symptoms can lead to overall poor quality of life and financial burdens on the healthcare system. A combination of antiemetics and prokinetics is used in symptom control; metoclopramide is the main prokinetic available for clinical use and is the only U.S. Food and Drug Administration-approved agent in the United States...
2018: Clinical and Experimental Gastroenterology
Thomas Gan, Andre Rickenbach, Matthew Scott-Young
Chronic persistent lower back pain due to degenerative disc disease (DDD) of the lumbar spine is a common condition in the athletic population, which does not always improve with nonoperative treatment. We present a case report of a professional Australian rugby league player with DDD of the lumbar spine presenting with persistent lower back pain, which was not responding to conventional nonsurgical treatment. He then underwent a surgical total disc replacement of the lumbar spine and was subsequently able to return to playing professional rugby league at his previous level of competition...
October 9, 2018: Clinical Journal of Sport Medicine: Official Journal of the Canadian Academy of Sport Medicine
Gaston Echaniz, Marcos De Miguel, Glenn Merritt, Plinio Sierra, Pranjal Bora, Nabamallika Borah, Christopher Ciarallo, Miriam de Nadal, Richard J Ing, Adrian Bosenberg
BACKGROUND: Cleft defects are common craniofacial malformations which require early surgical repair. These patients are at high risk of postoperative airway obstruction and respiratory failure. Cleft surgery may require high doses of opioids which may contribute to these complications. OBJECTIVES: To compare the effectiveness of proximal and distal approaches to blocking the maxillary nerve in patients undergoing cleft lip or cleft palate surgery. DESIGN: Randomised, controlled and double-blind study...
October 10, 2018: European Journal of Anaesthesiology
Yujie Yuan, Jidong Zuo, Weigang Dai, Weidong Feng, Weixin Xiong, Jinfu Tan, Min Tan
PURPOSE: Nowadays, biological matrix has become more widely applied than synthetic mesh for the surgical management of ventral hernia. Conventionally, such biodegradable matrix is commonly placed in an intraperitoneal or extraperitoneal position to reinforce the abdominal wall during surgery. Herein, we introduce our novel idea to deliver such biological material. MATERIAL AND METHODS: After contrast-enhanced CT-scan via lateral decubitus confirmed the position of ventral hernias, 11 patients underwent deperitoneum biological mesh repair by open or laparoscopic approach...
October 11, 2018: Minimally Invasive Therapy & Allied Technologies: MITAT
Mohammed A Khalid, William M Weiss, Michael Iloanya, Vinod K Panchbhavi
BACKGROUND: Chronic Achilles tendon ruptures are uncommon and increase long-term morbidity when untreated. There is no standard treatment for this condition. METHODS: Chronic Achilles tendon rupture was repaired in 10 patients by harvesting the flexor hallucis longus tendon (FHL) using a minimally invasive technique. It was then transferred to the calcaneus and the remnant used to bridge the gap for reconstructing the Achilles tendon itself. The patients were assessed using the American Orthopaedic Foot and Ankle Score (AOFAS) Ankle-Hindfoot Scale...
October 11, 2018: Foot & Ankle Specialist
Kiran Shah, Ashley G Zhao, Huseyin Sumer
Osteoarthritis is one of the most common chronic health problems in the world that causes disability and chronic pain with reduced mobility and is a progressive degenerative disease in weight-bearing joints such as the knee. The pathology of the joint resulting from OA includes loss of cartilage volume and cartilage lesions leading to inflammation of the articular joint structures; its incidence and progression are associated with a variety of risk factors. Most of the current treatments focus on symptom management such as physical and occupational therapies, pharmacological intervention for pain management, and surgical intervention with limited success and do not address nor halt the progression of the disease...
2018: Stem Cells International
Gajanan Bhat, Vijaykumar Barude, S Anuradha, Vinayak Tembadamani, Suman Hegde
Renal replacement lipomatosis is a rare benign renal disorder where the renal parenchyma is replaced by mature fatty tissue. It poses a diagnostic challenge to the clinicians due to an unusual presentation and clinical features. The disease usually presents in middle age with vague pain in the affected flank and variable urological symptoms. Although the condition is preceded by calculus disease or chronic inflammation, as an extremely rare occurrence, it can occur without any pre-existing condition, as in our case...
2018: Turkish Journal of Surgery
Roland Kadaj-Lipka, Michał Lipiński, Krystian Adrych, Marek Durlik, Anita Gąsiorowska, Mirosław Jarosz, Grażyna Jurkowska, Ewa Małecka-Panas, Grzegorz Oracz, Mariusz Rosołowski, Barbara Skrzydło-Radomańska, Renata Talar-Wojnarowska, Grażyna Rydzewska
This article describes the latest diagnostic and therapeutic recommendations in chronic pancreatitis, developed by the Working Group of the Polish Society of Gastroenterology and the Polish Pancreas Club. The recommendations refer to the diagnosis of chronic pancreatitis, autoimmune pancreatitis, conservative management, treatment of pain, and exocrine and endocrine pancreatic insufficiency, treatment of chronic pancreatitis by endoscopic and surgical methods, and oncological surveillance of chronic pancreatitis...
2018: Przegla̜d Gastroenterologiczny
Olivia Cardenas-Trowers, Kristine Kjellsson, Kenneth Hatch
INTRODUCTION: The objective of this video is to highlight strategies to improve operating room (OR) ergonomics, which will result in increased surgeon comfort during minimally invasive gynecologic surgery and decreased risk of musculoskeletal injury. METHODS: Work-related musculoskeletal disorders (WMSDs) are prevalent among surgeons, including those who perform minimally invasive gynecologic surgery. WMSDs are repetitive strain injuries that can damage a surgeon's muscles, nerves, and/or joints and commonly affect the neck, back, wrist, and hands...
July 2018: International Urogynecology Journal
Christian Benzing, Hans-Michael Hau, Georgi Atanasov, Felix Krenzien, Tim Eisenhauer, Johannes Broschewitz, Michael Bartels, Moritz Schmelzle, Georg Wiltberger
INTRODUCTION:  There are several well-established surgical procedures for the treatment of chronic pancreatitis (CP). The present study seeks to evaluate the perioperative and long-term outcome of these procedures. METHODS:  All patients who had undergone pancreaticoduodenectomy (PD), duodenum-preserving pancreatic head resection (DPPHR), and distal pancreatectomy (DP) for CP were retrospectively analyzed with regards to the perioperative outcome and long-term survival...
October 8, 2018: Zeitschrift Für Gastroenterologie
Dipesh H Vasant, Ramya Kalaiselvan, Joanne Ablett, Ashley Bond, Arun Abraham, Antje Teubner, Darren Green, Peter A Paine, Simon Lal
BACKGROUND & AIMS: Severe gastrointestinal dysmotility (GID) is a significant cause of chronic intestinal failure (CIF) with unclear benefits of sub-classifying into Chronic Intestinal Pseudo-obstruction (CIPO) and non-CIPO sub-types. We compared outcomes between CIPO and non-CIPO sub-types in a tertiary cohort of patients with CIF resulting from severe GID. METHODS: Adults with primary GID, commenced on home parenteral nutrition (HPN) over a 16-year period at a national referral centre, were included...
September 22, 2018: Clinical Nutrition: Official Journal of the European Society of Parenteral and Enteral Nutrition
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